title: Clinical and angiographic follow-up of small vessel lesions treated with paclitaxel-eluting stents (from the TRUE Registry).
abstract: Several randomized trials have shown that sirolimus-eluting stents and paclitaxel-eluting stents (PES) are effective in reducing restenosis in respect to bare-metal stents, including the subset of small vessels. The objective of this study was to evaluate "real world" angiographic and clinical outcomes of a large series of patients enrolled in the TRUE registry and treated with PES for both small vessel and very small vessel lesions. A consecutive series of 675 patients (926 lesions) with reference vessel diameter <2.75 mm measured by quantitative coronary angiography analysis were analyzed. The primary end point was the rate of angiographic in-stent restenosis and 1-year major adverse cardiac events. In this study 390 lesions were identified as small vessel (reference vessel diameter >or=2.25 and <2.75 mm) and 536 lesions as very small vessel (reference vessel diameter <2.25 mm). Overall in-stent restenosis was 15.5% (n = 96). Compared with small vessel, the very small vessel lesions had more in-stent restenosis (21.7% vs 11.4%, p <0.001) and in-segment restenosis (29.3% vs 22.5%, p = 0.055). The majority of the restenotic lesions (n = 125) were focal (57%, n = 71). At 1 year, cardiac death was 1.6% (n = 11), acute myocardial infarction 0.5% (n = 4.), and the target lesion revascularization 12.8% (n = 86). Cumulative major adverse cardiac events rate was 17.3% (n = 119). The rate of definite and probable stent thrombosis was 0.9% (n = 8). In conclusion, in comparison with historical bare-metal stent controls, this large series of small vessel lesions treated with PES confirms previous results reporting the efficacy of PES in small vessels. The rate of subacute and late stent thrombosis was low in this subgroup of patients.
authors.affiliation: Interventional Cardiology Unit, San Raffaele Institute, Milan, Italy. cosmogodino@gmail.com
authors.forename: Cosmo
authors.initials: C
authors.lastname: Godino
authors.forename: Shinichi
authors.initials: S
authors.lastname: Furuichi
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.forename: Nuccia
authors.initials: N
authors.lastname: Morici
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Enrico
authors.initials: E
authors.lastname: Romagnoli
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Rossella
authors.initials: R
authors.lastname: Barbagallo
authors.forename: Michela
authors.initials: M
authors.lastname: Cera
authors.forename: David
authors.initials: D
authors.lastname: Antoniucci
authors.forename: Omer
authors.initials: O
authors.lastname: Goktekin
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.forename: Bernard
authors.initials: B
authors.lastname: Reimers
authors.forename: Eberhard
authors.initials: E
authors.lastname: Grube
authors.forename: Flavio
authors.initials: F
authors.lastname: Airoldi
authors.forename: Giuseppe M
authors.initials: GM
authors.lastname: Sangiorgi
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000627:therapeutic use*; D011446:Prospective Studies; D012042:Registries; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000627:therapeutic use
chemical_list: D020099:Coated Materials, Biocompatible; D050257:Tubulin Modulators; D017239:Paclitaxel